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Systematic review of prostaglandin analogues for retained placenta
Author(s) -
GrilloArdila Carlos F.,
AmayaGuio Jairo,
RuízParra Ariel I.,
AmayaRestrepo Juan C.
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12572
Subject(s) - ergometrine , medicine , retained placenta , placenta , misoprostol , relative risk , confidence interval , randomized controlled trial , oxytocin , prostaglandin , meta analysis , pregnancy , obstetrics , abortion , fetus , biology , genetics
Background Medical management of retained placenta could be a safe alternative to manual removal. Objective To evaluate the efficacy of prostaglandin analogues for retained placenta. Search strategy MEDLINE, EMBASE, CENTRAL, ICTRP, LILACS, and OpenSIGLE were searched without language restrictions from inception to January 31, 2017, by combining terms for retained placenta and prostaglandin analogues. Selection criteria Randomized controlled trials comparing prostaglandin analogues with any other intervention. Data collection and analysis Trials were independently assessed for inclusion, data extraction, and risk of bias. Data were extracted for meta‐analyses. GRADE was used to evaluate the quality of data. Main results Seven randomized controlled trials (851 patients) were included. Prostaglandins did not increase the placenta expulsion rate (relative risk [RR] 1.40, 95% confidence interval [CI] 0.83–2.36) or decrease maternal transfusion (RR 0.72, 95% CI 0.43–1.22). In comparison with oxytocin, prostaglandins did not modify the expulsion rate (RR 1.26, 95% CI 0.90–1.78), maternal transfusion (RR 1.05, 95% CI 0.27–4.09), or time for delivery of placenta (mean difference −1.56 minutes, 95% CI, −9.25–6.13). Three trials comparing prostaglandins with oxytocin agonists, ergometrine, and manual removal reported similar results. Conclusions Prostaglandin analogues do not offer an effective alternative for management of retained placenta.